Pregnancy is associated with metabolic adjustments including weight gain and changes in glucose and lipid metabolism. This regulatory fine-tuning takes place to support foetal growth and consequently a successful outcome of pregnancy but they may have long-term effects on maternal and child health such as disturbances in glucose metabolism.
Early pregnancy is characterized by normal tolerance to glucose and insulin. In late pregnancy, by contrast, an increase in serum insulin concentration accompanied by the development of insulin resistance is observed. These metabolic adaptations support foetal growth by shunting metabolic fuels to the foetus instead of the mother. However, in some pregnant women this adaptation process is exaggerated leading to impaired glucose tolerance. These individuals have an increased risk of developing gestational diabetes mellitus and consequently adult Type 2 diabetes mellitus. Impaired glucose metabolism in a pregnant woman may be associated with macrosomia and risk of impaired glucose tolerance in her child. These conditions may develop even when maternal glucose tolerance is within normal reference ranges i.e. not classified as gestational diabetes mellitus. This pathophysiology—higher than optimal glucose levels—is more common than might be anticipated and constitutes a leading cause of cardiovascular mortality in this group.
There is therefore a need to provide methods to reduce the risk of development of gestational diabetes and impaired glucose tolerance in pregnant women.